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Associations Between Cardiovascular Events and Nonergot Dopamine Agonists in Parkinson's Disease
Author(s) -
Crispo James A.G.,
Willis Allison W.,
Thibault Dylan P.,
Fortin Yannick,
Emons Matthew,
Bjerre Lise M.,
Kohen Dafna E.,
PerezLloret Santiago,
Mattison Donald,
Krewski Daniel
Publication year - 2015
Publication title -
movement disorders clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.754
H-Index - 18
ISSN - 2330-1619
DOI - 10.1002/mdc3.12286
Subject(s) - pramipexole , medicine , adverse effect , odds ratio , parkinson's disease , stroke (engine) , disease , relative risk , confidence interval , mechanical engineering , engineering
Background Knowledge of possible cardiovascular risks from Parkinson's disease ( PD ) medications is critical to informing safe and effective treatment decisions. The objective of our study was to determine whether PD patients treated with nonergot dopamine agonists ( DA s) are at increased risk of adverse cardiovascular or cerebrovascular outcomes, relative to PD patients receiving other treatments. Methods Matched case‐control studies were conducted within a cohort of 14,122 inpatients receiving treatment for PD who were identified in the Cerner Health Facts database. Primary outcomes were associations between nonergot DA use and diagnosis of adverse cardiovascular events (acute myocardial infarction, heart failure [ HF ], hypotension, and valvulopathy). Secondary outcomes included associations between nonergot DA use and diagnosis of adverse cerebrovascular events (cerebrovascular accident and ischemic stroke) and odds of significant exposure‐outcome relationships by patient factors. Results HF was the only adverse event that demonstrated a significant association with nonergot DA use. Individuals treated with pramipexole were more likely to be diagnosed with HF , relative to no use (adjusted odds ratio [ AOR ]: 1.28; 95% confidence interval [ CI ]: 1.07–1.53). The association between pramipexole and HF was greater among individuals treated with pramipexole monotherapy (relative to levodopa monotherapy) ( AOR , 1.50; 95% CI : 1.09–2.06). Compared to nonusers, men and older individuals treated with pramipexole were more likely to be diagnosed with HF . Conclusions Results from our study suggest an association between pramipexole use and HF . Findings warrant replication; however, individuals with PD and independent risk factors for, or a history of, HF may benefit from limited use of this drug.